Post on 17-Apr-2020
Social Cost of Groundwater Pollution in India Current Status, Challenges and Directions for future work
Sunderrajan Krishnan
Centre for Action, Research and Education in Water (CAREWATER), India Natural Resource Economics and Management Foundation,
Anand, Gujarat
Contents Why understand the social cost of Groundwater Pollution?
Some examples of Evaluating Impacts
Main Challenges
Outlines of a Methodology
Major Holes to fill and Directions for future
Studies Shah, Tushaar and Indu, Rajnarayan, 2004, Fluorosis in Gujarat: A Disaster Ahead, IWMITata Program Annual Partner's Meet, Anand
Raychoudhury T. and Krishnan S., 2007, Coastal Salinity in Junagadh, Gujarat, in Proceedings of International Groundwater Conference, Coimbatore
Indu R. and A. Rawal, 2007, Incidences of kidney stone in Mangrol Taluka, Junagadh district, presented in National Level Seminar on Crisis in Drinking Water in Coastal India, Ahmedabad
Indu R., Krishnan S. and T. Shah, 2007, Impacts of groundwater contamination with Fluoride and Arsenic: Affliction severity, medical cost and wage loss in some villages of India, International Journal of Rural Management, vol. 3, No. 1, pp 6994
Krishnan S., 2010, Groundwater quality in India: extant, impacts and mitigation, Report submitted to Planning Commission over impacts of Groundwater studies
Impact of Salinity in Coast of Kachchh and Saurashtra, Ongoing Study
Acknowledge: International Water Management Institute, Sir Dorabji Tata Trust, Sir Ratan Tata Trust, Public Health Foundation of India, Apollo Hospitals, Planning Commission
Why look at the Social Cost of GW Pollution?
There is currently investment from government, donors and private sector on addressing pollution problems
Various methods, technologies are being adopted
What is the impact of these measures?
What problems are they solving?
What social benefits are being created from these measures?
Social Cost of GW Pollution will be one component of this benefit
Multiple impacts; not understood well
Due to effluents from Industries No good estimates No good estimates
Industrial effluents
Multiple impacts; not understood well
Related to pesticide/fertilizer use in agriculture
No good estimates No good estimates
Agrochemicals
Diarrheal problems; DALY > 22 million years annually; total 4,50,000 deaths annually
Related to poor sanitation and hygiene practices; increased by malnutrition
No good estimates No good estimates
Biological
Iron overload; Cirrhosis; suspected Diarrhoel linkages; Cardiac linkages
Geogenic mainly; No good estimates 206 Iron
Arsenicosis ; DALY 527 per 1000 population
Complex geogenic processes not yet well understood; but suspected to be related to excessive use and related water table fluctuations; increased by malnutrition
5 million in WB; more in Assam, Bihar
35 Arsenic
Fluorosis; DALY = 38.5 per 1000 population; > Rs. 5000 per capita annual expenses
Inherent(geogenic), but aggravated also by overexploitation; increased by malnutrition
65 million 203 Fluoride
Kidney stones due to poor hydration in such areas (Rs. 7500 cost per family per year)
Inherent(geogenic)/Manmade (eg. coastal saline intrusion due to overpumping)
No estimates available 137 Salinity
Impact Cause Population affected/exposed
No. Districts
Quality problems
Disease Burden of Water Quality Problems in India
Source: Krishnan, 2009
Total pollution load Total pollution Load into Aquifers (mainly) = Load from Industries + Load from Agriculture + Load from Domestic waste
But aquifer pollution happens due to variety of processes eg. overpumping and salinity ingress
Current country level on macro level does not match with micro studies
Then, how do we arrive at an overall picture ?
The rate of pollutant load is a combination of direct inputs and due to indirect effects eg. pumping, well deepening, induced geochemical process
Social Cost of Fluorosis
• HydroFluorosis causes by consumption of high Fluoride in water
• Not just Dental and Skeletal Fluorosis, but variety of problems with brain, liver, kidney, heart diseases
• Estimates vary from 10 to 65 million people exposed
• DALY of 38.5 per 1000 population (NEERI, 2007)
Social Cost of Fluorosis
Source: CGWB
Fluorosis
Water
Food (black tea, rock salt) Occupation
(Mines, glass etching)
Nutrition (Ca, Mg, Vitamins)
Crops Metabolism
Society
Social, economic, cultural impacts (effect of medicines, wage loss, psychological setback)
Fluorosis mitigation programmes
• More than 50% of Fluoride intake can be through food grown locally
• Fluorosis is linked much with climatic and nutritive factors
• Teaching of Fluorosis is not present in current Indian medicine or engineering literature
• Fluorosis patients can incur high costs (wage + medicine losses)
Cost calculation:
• Medical cost = Medicine cost + Doctor’s cost ( cost taken in ranges )
• Wage loss = If unable to work because of Fluorosis, then total wage loss (partial or full)
Costs ignored:
• Impact on livestock’s productivity • Cumulative labour loss in society • Impact on village GDP • Intangible costs eg. social stigmas
Social cost of Fluorosis
16 % 21 % 6 % 26 % cost/an nual income
2.3 1.7 1.3 1.1 afflicted no/hous ehold
Rs. 12857 Rs. 8719 Rs. 19741 Rs. 4593 per capita annual
wage loss
Rs. 1724 Rs. 2807 Rs. 1489 Rs. 861 per capita
annual medical
cost
NorthKarnataka
(in 2005)
Kolar (in 2005)
Dausa (in 2005)
NorthGujar at
(in 2002)
Medical and Wage loss costs
Example of Total Burden From Fluorosis
DDWS Data: 25,069 habitations all over India affected
Taking Average of 625 population per habitation,
Total population exposed = 15.6 million
With Rs 5000 per capita per year social cost,
Total Potential Social Cost Annual = Rs. 7834 crores (a rough estimate, not to be quoted)
Problems with estimate:
Habitation data; AP reported as almost no Fluoride; Incidences of Fluorosis cases; Variable Social cost
Example of Total Burden From Fluorosis Cost of avoiding this burden Per capita 20 l / day
Cost of providing water: Rs 0.2/litre
Total cost per person = Rs 1460 /year
Total cost for 25 million exposed persons:
= Rs 2287 crores/year
Further action of nutrition enhancement is necessary to neutralize the entry of Fluoride through food
Fluorosis Mitigation Programmes in India (1970s till now)
• Most Fluorosis mitigation programmes have been water supply programmes
• We can make 4 categories of these mitigation programmes:
– Defluoridation at community level
– Defluoridation at individual level
– Water supply at regional level
– Clinical and focussed patient approach
• Started mainly as Defluoridation programmes
• Nalgonda filter (using Lime and Alum) in 1970s … NEERI
• Reverse Osmosis (RO) with proper membrane can remove Fluoride ions
Defluoridation at community level
• Based on Nalgonda techniquelime and alum method.
• Addition of aluminum salts, lime and bleaching power followed rapid mixing, flocculation, sedimentation, filtration and disinfection.
• However, none of the 300 plants installed all over India are functioning now
Defluoridation at community level
Source: R Reddy
Reasons for Failure of Nalgonda plants
Community failed to appreciate reason for water treatment
No involvement of Health agencies in planning Required high maintenance cost and time Difficult to recover costs for maintenance Aesthetic problems with treated water
Defluoridation at community level
RO for Defluoridation at community level Reverse Osmosis technology developed in 1960s for desalination and military purposes
Based on differential ion concentrations across a semi permeable membrane. Solute permeates through the membrane due to pressure from high to low concentration compartment
Started to be used in India since 1990s for drinking water purposes
Currently large market of domestic and large units
The most widely used technology for bottled water
Successfully operating RO plants in south Gujarat
100% 42% 10% Reach
325 86 30 Buyers in village
2500 litres 1200 litres 300 litres Prod/day Re 0.6 Re 0.28 0 Cost/litre 5 lakhs 2.32 lakhs 1.25 lakhs Plant cost
6000 litres 2000 litres 200 litres Storage 1000 lph 560 lph 250 lph Capacity
Maximum Average Minimum
Suppliers of plant are varied (ISO, nonISO)
Reach within village shows wide variation,
Offshoot water suppliers cover surrounding villages,
Nonusers have very poor drinking water facilities
Variability in size, cost/litre, % of reach and production
Debates with RO • Cost/litre • Effluent disposal • Does it really treat for required contaminants? • Maintenance • Is it safe for health? • Is it really required?
Treatment aspects of RO water
• RO treats only according to the specific membrane capacity
• Pre and post treatment is required
• Although pure distilled water can be harmful for health, NRC, 1983 reports no health based guideline for RO water
• Effluent for RO should be disposed properly, but currently no official safety standards exist in India
Domestic Defluoridation Programmes
Research in 1980s to overcome problems with Nalgonda technology
Search for low cost, low maintenance, no energy IIT Kanpur and UNICEF identified Activated Alumina (AA) as a suitable technology
AA adsorbs Fluoride ions to limited capacity Beyond this capacity, AA needs to be “regenerated” Cost of AA now is around Rs 80/kg Adsorption capacity is around 5000 mg per Kg of AA
Domestic Defluoridation Programmes
• Activated Alumina § Minimum of 1mg/g adsorption. Requires regeneration every 45 months § New materials with 89 mg/g adsorption § AlFl complexes a health concern § Has wide industry application, so is lowcost and available § AA filters not available in market § No electricity required
Two main programs for AA are SWACH and Mytry
• SWACH and Mytry
UNICEF and IITK tested the AA DDU filters and implemented in 2 locations
Awareness programmes, village regeneration centres
Mytry later transitioned into filter manufacturing company
Currently some maintenance of filters happens in Rajasthan, but not widespread
Domestic Defluoridation Programmes
Domestic Defluoridation Programmes
Reasons for failure of Domestic Defluoridation Programmes:
Addresses Fluoride only, whereas people are immediately concerned about TDS, taste, odour, bacterial contamination Maintenance aspect is intensive; services may be required Reinforcement from doctors absent Results not quick and reversal not very fast except for gastro problems
Water supply at regional level
• Many piped water supple schemes in operation now
• Some are in successful operation, but most provide intermittent water
• O and M of schemes difficult; also assurance of the source
• Some positive results observed from our field studies showing hope with long term good water supply; New generation is safer from Fluorosis ; the food route is still present
Clinical and focussed patient based approach
Dr. AK Susheela
Nutrition : Amla, Anti oxidants, … preventing food with high Fluoride eg. tea … N delhi, Karbi Anglong, Dungarpur
Dr. SK Gupta
Asorbic acid (Vitamin C) and other nutrition measures. Reverse DF in children…. Jaipur
Clinical and focussed patient based approach
Dr. T Chakma
Mainly nutrition based measures – Chikora Bhaji – high Ca, reversed high SF in children … Mandla, Jhabua
Dr. R Reddy Identified Ca, Mg , Vitamin C as main nutrition deficiencies for Fluorosis patients …. Prakasham, Nalgonda
Observations from mitigation experiences Water supply program alone will not address Fluorosis mitigation
Demand needs to be generated for need for safer water
High costs might exclude some communities
Apart from water, nutrition and food is very important
Expectation of mitigation needs to be clearly defined: a) Which symptoms can be reversed b) To what degree can reversal happen c) What time frames will this take d) To what confidence will this happen
Social Cost of Salinity
Source: ICAR Studies
Example of Salinity Impact
Ailments caused/attributed to saline water
Renal stones (kidney stones) and related diseases
Skin diseases – eczema, scabies (particularly in winter), fungal patches, psoriasis etc.
Eye
Hypertension
Hair Loss and dandruff We are studying the first 3 ailments only
Incidences of ailments
Attribution to Saline water
Social cost from ailments
Hospital records, Health surveys
Delphi analysis with expert doctors
Field surveys of patients
Social cost of ailments attributed to consumption or exposure to saline water
X X
Ailments aggravated by saline water
Methodology
Total costs due to Kidney stones
In salinity affected villages,
• Medical costs = Rs. 5790 per person per year
• Wage loss costs = Rs. 2690 per person per year
• Drinking water costs = Rs. 750 per household per year
Social costs due to Kidney stones form a significant part of income
Key Methodological Challenges
Extant of contamination
Health Impact of Contamination on Population
Incidences of Health Impact
Social Cost Due to Health Impact
Attribution of Health Problem to Water Quality
Outlines of Methodology for nationwide picture
Construct Causal Picture of Water quality related Health Problems
Identify Attribution and Incidences
Estimate extant of Contamination
Sample Studies on Social Costs
Outlines of Methodology for nationwide picture
Overall Social Cost of
GW Pollution
Salinity Fluoride Arsenic Iron Agrochemicals Industrial chemicals
Biological contaminants
Other GW Quality Problems
Extent of Contamination Incidence
Causal Picture and
Attribution
Social Cost of Individual Patient
Overall Social Burden from Fluorosis
How does this total Social Burden Compare with our Total Investment for Mitigation?
Major Holes to Fill and Directions for Future
Accurate Picture of Groundwater contamination
Understanding of geochemical processes
Seeding Interest in Public Health agencies
Action Points for Mitigation
Process driven Aquifer clean up
Reducing Pollution Load
Providing drinking water services
Preventive Health , Early Diagnosis and Nutritive measures
Diverting Social cost to end product
Harnessing Rural Health Insurance for Preventive health measures eg. nutrition
In summary • Major Health Burden of Water Quality Problems • But our national databases are weak • Linkages of contamination to health problems are not well identified
• Cost of prevention is less than social cost of impacts
• Methodological Issues need to be sorted out